fasciculation

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Fasciculation

A fasciculation or "muscle twitch", is a small, local, involuntary muscle

contraction and relaxation visible under the skin arising from the spontaneous

discharge of a bundle ofskeletal muscle fibers (muscle fascicle).

Fasciculations have a variety of causes, the majority of which are benign, but can

also be due to disease of the motor neurons.

Causes and riskfactors

1. The origin of most cases is at present unknown and usually inconclusive, hastherefore been given the title benign fasciculation syndrome.

[1]

2. Neuromyotonia/Isaacs syndrome3. Lower motor neuron lesion4. Werdnig-Hoffman disease5. Amyotrophic lateral sclerosis6. Kennedy disease7. Organophosphate poisoning8. Benzodiazepine withdrawal9. Magnesium deficiency (which can be caused by stress)10. Myalgic Encephalomyelitis11. Dehydration12. Fatigue13. Lyme Disease14. Myasthenia Gravis15. Rabies16. Fibromyalgia

Medications

1. Other risk factors may include the use ofanticholinergic drugs over long periods,in particularethanolamines such as Benadryl, used as an antihistamine and sleep

aid, and Dramamine for nausea and motion sickness

2. Persons withbenign fasciculation syndrome (BFS) may experienceparaesthesiashortly after taking such medication; fasciculation episodes begin as the

medication wears off.3. Stimulants can cause fasciculations directly4. These include caffeine,pseudoephedrine (Sudafed),5. amphetamines, and the6. asthmabronchodilatorsalbuterol/salbutamol (e.g. Proventil, Combivent,

Ventolin).


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7. Medications used to treat attention deficit disorderoften contain stimulants as well,and are common causes of benign fasciculations

8. The depolarizing neuromuscular blocker, succinylcholine, causes fasciculations.9. It is a normal side effect of the drug's administration, and can be prevented with a

small dose of a nondepolarizing neuromuscular blocker prior to the administrationof succinylcholine, often 10% of a nondepolarizing NMB's induction dose.

10. Fasciculations can happen in any muscle in the body.

Treatment

1. Inadequate magnesium intake can cause fasciculations,2. especially after a magnesium loss due to severe diarrhea.3. Over-exertion is another risk factor for magnesium loss. As 70-80% of the adult

population does not consume the recommended daily amount of magnesium,[2]

4.

inadequate intake may also be a common cause.5. Treatment consists of increased intake of magnesium -rich food, such as nuts(especially almonds) and bananas.

6. Magnesium supplements may also be taken, however too much magnesium maycause diarrhea, causing dehydration and nutrient loss (including magnesium).

7. Fasciculation also often occurs during a rest period after sustained stress, such asthat brought on by unconsciously tense muscles. Reducing stress and anxiety is

therefore another useful treatment.


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Fibrillation

Fibrillation is the rapid, irregular, and unsynchronized contraction of muscle fibers. An

important occurrence is with regards to the heart

Cardiology

1. There are two major classes of cardiac fibrillation: atrial fibrillation and ventricularfibrillation.

2. Atrial fibrillation can be a chronic condition, usually treated with anticoagulationand sometimes with conversion to normal sinus rhythm. This originates in the

Atrium and an electrical impulse is "quivering" (fibrillation). An electrical pulse isgiven off, but is not the optimal way of sending an electrical pulse.

3. Ventricular fibrillation is rapidly fatal if not reversed by defibrillation. No electricalimpulse is given off in this form of dysrhythmia.

4. Fibrillation may sometimes be used after heart surgery to stop the heart frombeating while any minor leaks are stitched up

.Musculoskeletal

1. Fibrillation also occurs with individual skeletal muscle fibers. [1]2. This happens when muscle bers lose contact with their innervating axon producing

a spontaneous action potential, "fibrillation potential" that results in the muscle

fiber's contraction.3. These contractions are not visible under the skin and are detectable through needle

electromyography (EMG) and ultrasound.[2]

4. Fibrillations do not occur in healthy individuals.5. They are a major symptom in acute and severe peripheral nerve disorders, in

myopathies in which muscle bers are split or inammed, and lower motor neuronlesions.

6. They contrast with fasciculations that are visible spontaneous contractionsinvolvingsmall groups of muscle fibers. Also, fasciculation does not necessarilydenote pathology, as does fibrillation, although it can be seen in lower motor

neuron lesions as well


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